3-25. MAFENIDE ACETATE (SULFAMYLONR)
a. Advantages. This medication is the best choice for treating a highly
contaminated wound. SulfamylonR penetrates through eschar. After application, the
wound is visible. This medication has broad anti-gram negative activity and does not
impede the motion of joints.
b. Disadvantages. There are several disadvantages to using mafenide acetate.
First, use of this medication tends to cause casualty to hyperventilate. That is, the
casualty breathes too deeply and upsets the carbon dioxide balance in his body. The
result is that the casualty experiences buzzing in the ears, tingling of the lips and
fingers, and sometimes fainting. Secondly, mafenide acetate is very painful when
applied or removed. Thirdly, this medication may delay the formation of new tissue.
Finally, the casualty may be hypersensitive to this medication.
3-26. SILVER NITRATE DRESSING
a. Advantages. Use this treatment if topical, antimicrobial creams are not
available. Apply multi-layered occlusive gauze dressings. Change the dressings two to
three times a day, moistening the dressings every two hours to prevent the dressings
from becoming dry. Silver nitrate soaks have broad, anti-gram-negative activity. This
medication decreases the wound heat loss.
b. Disadvantages. Application of the medication on the burn area is painful.
The medication does not penetrate the eschar. The soaks promote electrolyte
imbalance by causing losses of sodium, potassium chloride, and calcium. Dressings
impair joint motion and retain heat, and the soaks discolor the skin and the surrounding
environment. These dressings, sometimes called silver nitrate soaks, are often
ineffective when used on a wound which has an established infection.
Burns are among the most potentially dangerous and most common life-
threatening injuries. A casualty with burns needs immediate treatment. Proper
knowledge and prompt treatment for burns could save a life.